Provider Demographics
NPI:1275885030
Name:BREWER, NANCY LOUISE (FNP)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:LOUISE
Last Name:BREWER
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:NANCY
Other - Middle Name:LOUISE
Other - Last Name:FLACHMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP
Mailing Address - Street 1:3201 W PEORIA AVE
Mailing Address - Street 2:STE A100
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85029-4609
Mailing Address - Country:US
Mailing Address - Phone:602-866-1501
Mailing Address - Fax:602-866-2216
Practice Address - Street 1:3800 E SKY HARBOR BLVD FL T4
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85034
Practice Address - Country:US
Practice Address - Phone:480-333-7244
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-10-03
Last Update Date:2020-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAP4676363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care